The development of innovative new programs and payment models that reward physicians who deliver high quality and efficient care has been a priority for the ACC over the last several years in light of health care reform and the need to curb out-of-control health care costs. On Feb. 7, 2012 the College had an opportunity to share the initial outcomes of the efforts and discuss possibilities for the future at a special hearing held by the House Ways and Means Subcommittee on Health.

Past ACC CEO Jack Lewin, MD, testified on behalf of the College about several of the exciting quality improvement collaborations underway in cardiology and what lessons can be applied across the health care system to simultaneously reduce unnecessary admissions, readmissions, complications, testing, and ineffective spending.

In particular, his testimony focused on the power of data as exemplified by ACC’s experience with the NCDR^® and the importance of decision support tools in helping care providers actually use evidence-based guidelines and appropriate use criteria to “get science to the point of care” to ensure not only the right therapy and/or test, but also engage patients in the decision making process. Lewin also focused on the ways the ACC is currently working to “put the data to work” through programs like Hospital to Home, Imaging in FOCUS and PINNACLE. All three programs use data to identify area for improvement and then provide networking and educational support for sharing of best practices and performance improvement. 

The testimony highlighted the College’s newest undertakings in Wisconsin and Florida that combine data collection, decision support and quality improvement initiatives into a focused project that documents clinical quality, resource use and cost variation in the treatment of stable ischemic heart disease. These “SMARTCare” projects which are driven by the ACC’s state chapters and the ACC in collaboration with integrated health care systems, payers and multi-stakeholder collaborative groups are examples of programs that are on track to ensure appropriate care based on the latest science, reduced costs and high levels of patient engagement in the care process. 

Dr. Lewin called on Medicare and private payers to encourage, through incentives, the development and widespread use of clinical data registries that allow the tracking and improvement of health care quality in concert with payment programs that encourage higher quality. “The pathway to reducing the rate of growth of U.S. health care spending and its alarming contribution to the national deficit will require that we align payment incentives with improved data-driven outcomes,” he said. “The task requires improving care rather than cutting care and physician leadership, working together with other clinicians, hospitals, insurers, and Medicare, will be necessary to effect these needed improvements in our health care system.”

Lewin elaborated on shared decision making and how programs like the College’s CardioSmart nationwide health initiative will empower patients and encourage their involvement and understanding of cardiovascular disease and impacts of lifestyle choices. 

Other speakers at the hearing included Lewis G. Sandy, MD, senior vice president, Clinical Advancement, UnitedHealth Group; David Share, MD, MPH, vice president, Value Partnerships, Blue Cross Blue Shield Michigan;  John L. Bender, MD president and CEO, Miramont Family Medicine; and Len Nichols, director, Center for Health Policy Research and Ethics and Editor-in-Chief of the ACC’s online Payment Innovation Community.

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